- What is cervical cancer?
- What are the risk factors for cervical cancer?
- Can cervical cancer be prevented?
- The American Cancer Society guidelines for the prevention and early detection of cervical cancer
- The HPV DNA test
- The Pap test
- Work-up of abnormal Pap test results
- Cervical cancer prevention and screening: Financial issues
- Additional resources
Can cervical cancer be prevented?
The most common form of cervical cancer starts with pre-cancerous changes, and there are ways to stop this disease from developing. The first way is to find and treat pre-cancers before they become true cancers, and the second is to prevent the pre-cancers.
Finding cervical pre-cancers
A well-proven way to prevent cervix cancer is to have testing (screening) to find pre-cancers before they can turn into invasive cancer. The Pap test (or Pap smear) and the human papilloma virus (HPV) test are used for this. If a pre-cancer is found, it can be treated, stopping cervical cancer before it really starts. Most invasive cervical cancers are found in women who have not had regular Pap tests.
The Pap test is a procedure used to collect cells from the cervix so that they can be looked at under a microscope to find cancer and pre-cancer. A Pap test can be done during a pelvic exam, but not all pelvic exams include a Pap test.
An HPV test can be done on the same sample of cells collected from the Pap test.
Things to do to prevent pre-cancers and cancers
Avoid contact with the human papilloma virus (HPV)
Since HPV is the main cause of cervical cancer and pre-cancer, avoiding exposure to HPV could help you prevent this disease. HPV is passed from one person to another during skin-to-skin contact with an infected area of the body. Although HPV can be spread during sex − including vaginal, anal, and oral sex − sex doesn't have to occur for the infection to spread. All that is needed is skin-to-skin contact with an area of the body infected with HPV. This means that the virus can be spread through genital-to-genital contact (without sex). It is even possible for a genital infection to spread through hand-to-genital contact.
Also, HPV infection seems to be able to be spread from one part of the body to another. This means that an infection may start in the cervix and then spread to the vagina and vulva.
It can be very hard not to be exposed to HPV. It may be possible to prevent genital HPV infection by not allowing others to have contact with your anal or genital area, but even then there might be other ways to become infected that aren’t yet clear. For example, sharing sex toys might spread HPV.
HPV infection in women
Any woman who has ever had sex is at risk for genital HPV. Other risks include:
- Having many sex partners
- Having a partner who has had many partners
- Being younger than 25 years of age
- Starting to have sex at an early age (16 years or younger)
- Having a male partner who’s not circumcised (hasn’t had the foreskin of the penis removed). Men who still have their foreskins are more likely to get and stay infected with human papilloma virus (HPV) and pass it on to their partners.
Waiting to have sex until you are older can help you avoid HPV. It also helps to limit your number of sex partners and to avoid having sex with someone who has had many other sex partners. Although the virus most often spreads between a man and a woman, HPV infection and cervical cancer also are seen in women who have only had sex with other women. Remember that someone can have HPV for years and still have no symptoms. Someone can have the virus and pass it on without knowing it.
HPV infection in men
Any man who has ever had sex is at risk for genital HPV. Other risks include:
- Having many sex partners
- Not being circumcised (not having had the foreskin of the penis removed). Men who are circumcised have a lower chance of getting and staying infected with HPV compared to men who still have their foreskins. The reasons for this are unclear. Circumcision does not completely protect against HPV infection – men who are circumcised can still get HPV and pass it on to their partners.
Condoms (“rubbers”) provide some protection against HPV but they don’t completely prevent infection. Men who use condoms are less likely to be infected with HPV and to pass it on to their partners. Some studies suggest using condoms correctly every time you have sex may lower the HPV infection rate by about 70%. One reason that condoms cannot protect completely is because they don’t cover every possible HPV-infected area of the body, such as skin of the genital or anal area. Still, condoms provide some protection against HPV, and they also help protect against HIV and some other sexually transmitted infections. Condoms (when used by the male partner) also seem to help the HPV infection and cervical pre-cancers go away faster.
Female condoms fit inside the vagina and can help protect against pregnancy. They also can help protect against sexually transmitted infections, including HPV and HIV, although for this they aren’t as effective as male condoms.
Not smoking is another important way to reduce the risk of cervical pre-cancer and cancer.
Vaccines are available that can protect against certain HPV infections. These vaccines protect against infection with the HPV subtypes most commonly linked to cancer, as well as some types that can cause anal and genital warts.
These vaccines only work to prevent HPV infection − they will not treat an infection that is already there. That is why, to be most effective, the HPV vaccines should be given before a person becomes exposed to HPV (such as through sexual activity).
These vaccines help prevent pre-cancers and cancers of the cervix. Some HPV vaccines are also approved to help prevent other types of cancers and anal and genital warts.
The vaccines require a series of injections (shots). Side effects are usually mild. The most common one is short-term redness, swelling, and soreness at the injection site. Rarely, a young woman will faint shortly after the vaccine injection.
The American Cancer Society recommendations for HPV vaccine use are similar to those from the federal Advisory Committee on Immunization Practices (ACIP), and include the following:
· Routine HPV vaccination for girls and boys should be started at age 11 or 12. The vaccination series can be started as early as age 9.
· HPV vaccination is also recommended for females 13 to 26 years old and for males 13 to 21 years old who have not started the vaccines, or who have started but not completed the series. Males 22 to 26 years old may also be vaccinated.*
· HPV vaccination is also recommended through age 26 for men who have sex with men and for people with weakened immune systems (including people with HIV infection), if they have not previously been vaccinated.
*For people 22 to 26 years old who have not started the vaccines, or who have started but not completed the series, it’s important to know that vaccination at older ages is less effective in lowering cancer risk.
It’s important to realize that no vaccine provides complete protection against all cancer-causing types of HPV, so routine cervical cancer screening is still necessary.
For more information on the vaccine and HPV, please see HPV Vaccines.
Last Medical Review: 11/20/2016
Last Revised: 12/08/2016